Brief observationInfluence of the menstrual cycle on the timing of acute coronary events in premenopausal women☆
Section snippets
Study sample
We studied 27 consecutive premenopausal women hospitalized between 1996 and 2000 for the treatment of an acute coronary syndrome (acute myocardial infarction or unstable angina). We excluded women with irregular menstrual cycles or previous hysterectomy, or who used oral contraceptives. The study was approved by the ethics committees of the two participating hospitals (Laval Hospital and Hôtel-Dieu de Lévis Hospital). All study participants provided written informed consent.
Definition of acute coronary events
The diagnosis of
Results
All women had at least one known risk factor for coronary artery disease; the most common was a family history of cardiovascular disease (Table). The mean (± SD) age of the 27 women was 43 ± 4 years (range, 33 to 51 years). Their mean menstrual cycle length was 26 ± 3 days. All of the acute coronary events (n = 27) occurred within the first half of the menstrual cycle (P <0.00001 compared with no events during the second half of the menstrual cycle). Significantly more women (19 vs. 8 women)
Discussion
Because coronary artery disease is infrequent in premenopausal women, the effect of acute hormonal fluctuations on the timing of cardiovascular disease events is not well defined. Our study shows that most premenopausal women who have an acute coronary event do so during menses, raising the possibility that low 17β-estradiol levels during menses are associated with, or perhaps contribute to, the increased risk of an acute coronary event. However, none of the coronary events occurred during the
Acknowledgements
We would like to thank Jacynthe Harnois, RN, from Laval Hospital, for her assistance. We would also like to acknowledge the recruitment contributions of Dr. Réjean Loisel, as well as Francine Dumont, RN, and Noëlla Bilodeau, RN, from the Hôtel-Dieu de Lévis Hospital.
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This study was funded by the Fonds de la Recherche en Santé du Québec, Montreal, Quebec, Canada, and the Canadian Institutes of Health Research, Ottawa, Canada. Julie Méthot is a Research Scholar from the Canadian Institutes of Health Research.